Müller H, Volkholz H, Stolte M
Institute of Pathology, Klinikum Bayreuth, D-95445 Bayreuth, Germany.
Digestion. 2001;63(1):14-9. doi: 10.1159/000051867.
It is not yet clear whether lymphocytic gastritis might not be a sequela of Helicobacter pylori (Hp) infection. The aim of the present pilot study was, therefore, to investigate whether lymphocytic gastritis can be cured by Hp eradication, which, if affirmed, would provide indirect evidence for an etiopathogenic relationship.
98 of 220 patients with lymphocytic gastritis diagnosed between 1988 and 1998 were investigated at least twice, with 61 of them undergoing Hp eradication treatment. In 29 of these patients, the pretreatment histological work-up using the Warthin-Starry silver stain revealed Hp colonisation, while in the remaining 32 patients the biopsies from the antrum and corpus were negative for Hp. The other 37 patients received no treatment, and served as a control group.
Both in the group with Hp-positive, and in the group with Hp-negative histology prior to treatment, eradication treatment led to healing of the gastritis, i.e. to regression of the gastritis parameters including normalisation of the intra-epithelial lymphocyte count, in 93.1% and 84.3% of the cases, respectively. In the control group the histological findings did not change.
The results of our retrospective study support the notion that most cases of lymphocytic gastritis might be a consequence of Hp infection. This, however, needs to be clarified definitively by a prospective, randomized, double-blind study.
淋巴细胞性胃炎是否可能不是幽门螺杆菌(Hp)感染的后遗症尚不清楚。因此,本初步研究的目的是调查Hp根除治疗能否治愈淋巴细胞性胃炎,如果得到肯定,将为病因关系提供间接证据。
对1988年至1998年间诊断为淋巴细胞性胃炎的220例患者中的98例进行了至少两次调查,其中61例接受了Hp根除治疗。在这些患者中,29例经Warthin-Starry银染色进行的预处理组织学检查显示有Hp定植,而其余32例患者胃窦和胃体活检Hp为阴性。另外37例患者未接受治疗,作为对照组。
在治疗前Hp阳性组和Hp阴性组织学组中,根除治疗分别使93.1%和84.3%的病例的胃炎愈合,即胃炎参数恢复正常,包括上皮内淋巴细胞计数正常化。对照组的组织学结果没有变化。
我们的回顾性研究结果支持大多数淋巴细胞性胃炎病例可能是Hp感染的结果这一观点。然而,这需要通过前瞻性、随机、双盲研究来明确。